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Sorry, you may have posted about this before, but is it time to step in and insist, rather than hope?

My MIL has never forgiven us for telling her she had to stop driving. However, now the very stressful insurance process has started for the "writing on the wall incident" (her backing into a stationary motor bike rider) she can see she should not have been driving and has stopped complaining about it.

That generation hate using taxis, and it's normal to cling to the driving license for as long as possible. But having a plan for when driving becomes too difficult is probably one of the most important things to sort out in older age. Including facing up to the fact that if your home is not near public transport it probably won't work for ever.

It’s hideous, isn’t it? People prepare us for babies and teenagers. We go to classes.

Elderly parents… no.

Can I ask when the worrying stops?

Hello.
Can I join?

Well the elderly relative who was paying "HOW much?!!" for car insurance had one of those "moments" today and drove into (well - through!) the garage doors. Luckily just shaken up. God bless modern car safety features.

And it's also lucky that the garage doesn't have a door into the house.

In any case I knew I couldn't manhandle heavy wooden garage doors and said they should ring an emergency boarding-up service. I was kind of glad that this was something I couldn't help with, as for separate reasons I was completely wiped (after the phone call I slept all afternoon without lunch) and didn't feel safe myself (ironically) to be driving today.

Hopefully this will prompt a switch to using taxis (I would take "fancy new car with features to save you from yourself" if there was something suitable - I do get wanting to have your own transport).

Sorry to hear it, all you can do is keep repeating that like a broken record. Good luck. 🤞🏻

That is just one of many emails I’ve sent her and unfortunately my mum is doing all of the above you mention 🥲 and they know about it.

unfortunately, asking after relatives that died years ago isn’t of itself enough of a justification for 24 hour care. While it’s evidence that the person concerned has memory issues, the case for 24h care will need to be made on safety. Is she safe to be left on her own/unsupervised between carer visits? You and the two doctors obviously think not, and so that is the point that needs to be emphasised to SW. Examples such as wandering outside the house, unsafe use of electric, gas and water, fall risks, leaving the house unlocked, opening up the house to strangers. The kind of thing where the answer isn’t 4x a day carer visit.

Email sent to SW yesterday:

Thank you for update. I've just left my mum and she is more settled however that is because she is medicated.

She is under the impression my father is alive and is asking after relatives who died more than 35 years ago and if they will be visiting. Furthermore, she believes she has 2 houses, where she hasn’t lived for 50 years.

SW has called to advise that my mum doesn't meet requirements for 24 hour care following an assessment. This is a direct contradiction with conversation held with Dr *** yesterday and my mums own GP. I have yet again raised my concerns and advised I will not be able to continue in a caring capacity for my mum should they discharge her

@Patsy7299 sorryto hear this- useful phrases used with effect by board members here in the past include” unsafe discharge” “ risk of readmission”( not good for their stats) and “ carer breakdown”.

They think I’ll be doing what I did previously which caused complete burn out.I’ve told them no. I cannot believe that SW deem her fit. Thank you for suggestions re cottage hospital, I am sure there is one and will be adding that to my list when I speak to them! They’ve assessed her in a ward where she goes from bed to chair and eats what’s out in front of her. She cannot do a thing at home plus was wandering and believed she could drive!

@Patsy7299 it seems really odd as others have said that SW is supporting discharge as surely they will have to organise care and fund it? Some hospitals have discharge coordinators especially where patient lacks capacity, although that can backfire too!

stick to your guns, if you are not able to provide care SS have to act with duty of care surely? It’s a mess as different NHS trusts have differing solutions, we were luckily first time with MiL as we have a sort of cottage hospital set up with wards for people who still need nursing care but not full hospital with surgery wards etc. Then assessment is done again.

the assumption seems to be that magic fairies, usually female, will appear to do lots of the caring. DS had elderly lady with cancer and other health problems, but her own DD was blind and lived 5 miles away. All the neighbours ran errands and kept an eye out for her, mostly female fairies and mostly also working and/or with young families.

you could also contact the hospitals PALS.

🤞

@MereDintofPandiculation I hope all continues to go better for your DH.

@NoBinturongsHereMate thank you for sharing those NICE guidelines and being specific.

@Patsy7299 I’m so sorry the SW is putting you through this. I cannot understand how SW can go against the medical advice in your DMs case. We had doctors saying unsafe and 24 hour care for DF after they’d assessed over a number of days and MDT had discussed his case.

SW had a chat with DF, had another MCA done on the ward contradicting the MDT and pushed to discharge with a home care package of visiting care.

Wishing you strength to keep saying no, unsafe discharge and that a care home is the only way.

Here's the one I was thinking of: https://www.nice.org.uk/guidance/ng27/chapter/Recommendations

Especially 1.3.5, 1.3.8 and most of section 1.5.

Not the one I was after, but could be useful later or to others:

https://www.nice.org.uk/guidance/ng22/chapter/Recommendations

Hang on, I'll find an official thing you can wave at them..

I don’t but I’ll find out, thank you!

Good result, @KittyCatsby !

I hope the 'scan in 2 months' is a sign they don't think it's anything too alarming, @MereDintofPandiculation .

@Patsy7299 I think your everything in writing plan is a good one. Keep using the words 'unsafe discharge' and reiterate that the consultant agrees. Do you have a named discharge coordinator?

What's the outcome for your stepdad, will they operate eventually once they’ve sorted his heart, or is the oncologist now taking a different tack?

Plan is to operate. There is a chemo option but usually only used as second line treatment - no idea if it's worth doing on it's own. If they can't get his heart stable for the 3-month target it might need a rethink.

Thank you all for previous advice and apologies for asking again.

My DM was admitted under an emergency AWI last week. She has then be detained under 28 day order pending assessment. Her consultant phoned me yesterday as did her GP & both advised she requires 24 hr care. SW carried out assessment & believe she’s safe to discharge (she’s absolutely not) & I told them flat I won’t be supporting her in any way (been signed off with nervous exhaustion).

I have asked for assessment in writing and advised I’ll respond in return in writing. I am up the wall with anxiety & cannot go back to caring for her as I was. Any advice on handling SW gratefully received. TIA

In the same theme, when DM was first referred for a possible Parkinson’s diagnosis, the wait list was above 60 weeks. The consultant actually wrote back and said given the age of the patient we recommend referring to Elderly Care as she might get seen quicker. In the end we inadvertently skipped the entire backlog when she got admitted due to her “funny turns” and she got the scans and diagnosis within 48 hours.

you can get excellent care in the NHS but the system for organising and delivering it effectively appears to be completely stuffed. Whats the outcome for your step dad @NoBinturongsHereMate, will they operate eventually once they’ve sorted his heart, or is the oncologist now taking a different tack?